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Single Gene Analysis

New Jersey rates for HCPCS 81204

Reads one particular gene in a sample and reports which versions of it the person carries. Testing focuses on that single gene rather than scanning broadly, so it answers a specific question that has already been narrowed down by symptoms, family history, or earlier testing.

Rates data updated July 2026.

How much does Single Gene Analysis cost?

$117

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $107 from a physician practice, and about $229 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$107$83.18 to $117
FacilityA hospital or hospital-owned outpatient department$229$178 to $646

How much rates vary

Facilitymedian $229 · 10th to 90th $138 to $1,380Professionalmedian $107 · 10th to 90th $72 to $166
$100$500$2K$10Kfacility $229professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$181.97
Typical High
$851.14
Aetna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$302.00
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$125.89
Typical High
$275.42
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$144.54
Typical High
$218.78
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$10,471.29
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$138.04
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$141.25

Where New Jersey sits

The same service costs 3.4 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 34th of 51

$117

AK $309DE $91.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.